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2 Pre lecture quiz true/falseThe kidneys do not begin to develop until the 12th week of gestation and start to function approximately 6 weeks later.There is just a single theory that applies to kidney stone formation.Most uncomplicated urinary tract infections (UTIs) are caused by Escherichia coli.Upper urinary tract infections differ from those of lower urinary tract infections in that they incite an acute inflammatory response with marked systemic manifestations of infection.Catheter-associated bacteriuria remains the most frequent cause of gram-negative septicemia in hospitalized patients.FT

3 Pre lecture quizAutosomal dominant polycystic kidney disease (ADPKD) is a systemic disorder that primarily affects the kidneys, resulting in the formation of fluid-filled __________ in both kidneys with the threat of progression to chronic renal failure.____________ refers to urine-filled dilatation of the renal pelvis and calices associated with progressive atrophy of the kidney due to obstruction of the outflow of urine.Most kidney stones are composed of __________.Nephrotic syndrome is associated with increased glomerular permeability to the plasma __________, resulting in generalized edema.The __________ phenomenon, the process by which the urine released from the bladder washes out the bacteria out of the urethra, aids in maintaining the sterility of the urine formed in the kidneys and found in the bladder.calciumHydronephrosisproteinsacswashout

12 Scenario: Mr. K is paraplegic. When in the hospital, he had a catheterNow he has a high fever and complains of joint and back painHe has pyuria and reports urgencyBUN is 78 mg/dL (Normal 8-20 mg/dL)PCR is 4.7 mg/dL (Normal mg/dL)Question:What complication are you most worried about? Why?

13 QuestionTell whether the following statement is true or false: Urinary tract infections (UTIs) are usually caused by a virus.

14 AnswerFalse Rationale: UTIs are most often caused by bacteria that enter through the urethra (most common) or the bloodstream.

15 Structure of the GlomerulusGlomerular capillaries and Bowman’s capsule are both made of epithelial cells sitting on a basement membraneThey are so tightly attached to each other that they share one basement membraneThe epithelial cells of Bowman’s capsule stand up from the basement membrane on foot processes, leaving pores between the feet for filtrationUrineEpithelial cellFoot processesBasement membraneBlood in capillary

23 Scenario: She has severe edema and frothy, cola-colored urineA woman has diabetes mellitusShe has severe edema and frothy, cola-colored urineShe has difficulty breathing, with crackles in both lungsShe just finished a course of antibiotics for strep throatShe is also taking corticosteroids for lupus-related arthritisQuestion:What are three reasons for her renal problems?

24 Scenario (cont.)A woman has diabetes mellitus and lupus and recently had strep throat.She has severe edema and frothy, cola-colored urineQuestion:The doctor says the only way to determine what has caused her glomerular disease is a renal biopsy. Why?

25 Scenario (cont.) Urinalysis show that she is producing:Urine with 500 mg protein/ dayContains blood and RBC castsHigh level of K+Blood tests show:HypoalbuminemiaSlightly decreased K+She has borderline hypertensionQuestion:Does she have nephritic syndrome or nephrotic syndrome?